Here are all the articles I've written about Medical Bills. Enjoy!

June 30th, 2017

What a difference a week makes! SB 562 Update

Thanks for tuning in for our series on single payer!  What a difference a week makes; big update on SB 562.

On Friday, 6/23/17, CA Assembly Speaker Anthony Rendon (D-Lakewood) shelved the proposal saying it is “woefully incomplete” and has postponed any further legislative action until January 2018.

“If you think health care is expensive now, wait until you use what it costs when it’s free.”  – P.J. O’Rourke

The Insurance Mom’s colleague, Michael Lujan (one of CA’s best-known expert insurance legislative analysts) offers this in his amazing post on LinkedIn:

Single Payer (SP) would:

  • Replace all forms of private and public health insurance in California with a state government-run health system.
  • Would eliminate an estimated half million insurance, health care administration and related jobs, tripling our current unemployment rate. And without payroll contributions going into the system, there will be no money to pay unemployment benefits.
  • Could make California a health care destination for anyone seeking “free healthcare” as neither citizenship, nor permanent residency is required to use the SP system.
  • Requires massive tax increases. The additional 15% payroll tax would make California the highest taxed state in the country.

If enacted, The Healthy California Act (SB 562) would be the largest tax increase in California’s history. The entire state general fund is $183 billion. As proposed, the bill would cost an estimated $400 billion for the initial year and unknown costs for subsequent years. While that may seem like a deal-killer, the bill moved forward to the State Assembly and should not be ignored (when it resurfaces in 2018).

While this bill may be dead in the water, single payer / universal healthcare / socialized medicine / Medicare-for-all have been floating around the brains of the public.  The Insurance Mom wants her kiddies well-informed about …

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April 18th, 2017

Have You Heard? BIG changes coming to health insurance in 2018! BEWARE – BE AWARE!!

In 2018, if you’re buying individual health insurance for you and the fam (not through an employer),  PAY ATTENTION!
Open enrollment is scheduled to start NOVEMBER 1, 2017 (for new coverage starting January 1, 2018)
NEW RULE:  
Open enrollment will ONLY be for FORTY-FIVE days, ending December 15th.  That’s half of what it’s been in prior years.  YES!!!  No kidding.  PAY ATTENTION!!  
Health insurance will be harder to buy – or change —  in 2018. So The Insurance Mom wants you to really PAY ATTENTION!!  Outside of Open Enrollment (after 12/15/17) you’ll have to seriously PROVE that you’re eligible to buy health insurance or make changes to your plan.  It’s called a Qualifying Life Event.
 
MORE CHANGES:
  • The new rule could reduce the amount of federal subsidies that currently make premiums more affordable for low- and middle-income people
  • The new rule could allow insurance companies to offer even skinnier networks
  • The new rule could make coverage skinnier, too
PAY ATTENTION!   New regulations do NOT require Congressional approval… just the signature of a President.  If you’re not happy with the way things are going and are worried that you could lose the coverage you have, The Insurance Mom encourages you to contact your Members of Congress.
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August 17th, 2016

“What’s Up, Doc?” Blog Series Part 11: All Better… But OUCH, This BILL!!

Oodles of gratitude for taking this virtual trip to the doctor with us!  Here’s even more in the series “What’s Up, Doc?”  Catch up with parts one, two, three, four, five, six, seven, eightnine, and ten.

And now, our last in the series… “All Better… But Ouch, THIS BILL!!”

  1. Your doctor is IN-network right?    The doctor’s office MUST submit the bill (aka “the claim”) directly to your insurance company.
  2. The IN-network doctor CAN ask you for the office visit co-pay at the time of the visit.    But, for medical services done during the visit…
  3. The IN-network doctor canNOT charge you until after the insurance company applies the IN-network discounts (the negotiated rate).
  4. When you get a bill from the doctor’s office, be sure that the IN-network discounts have been applied.   How do you know?
  5. … because you got an Explanation of Benefits (EOB) from the insurance company!   Check the EOB against the provider’s bill, and THAT’s how you know you’re getting the right discounts.
  6. If the doctor is OUT-of-network you’ll be submitting your own claims to your insurance company – and the doctor can charge you whatever she likes, there are no discounts.
  7. If you have an HMO, you must ONLY see a doc in your HMO group.  There are NO benefits in an HMO if you go to an out-of-network doctor.

Talk to me!  Was this helpful?  What was your fave piece of info?  Suggestions and thoughts are welcome.  And as always, reach out to us for any of your insurance needs.…

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August 6th, 2016

Health Insurance Forecast for 2017– Are YOU Prepared?

Hello, Friends!

 

Are you ready for health insurance news for NEXT year??   Sit, get cawfee, or a cocktail and let’s tawk!

 

This interesting article from the NY Times and this one from the Free Beacon each have loads of important info, but here’s the gist….

 

The SAME news: the NEXT open enrollment period will be 11/1/16 through 1/31/17.

 

The HAPPY news: Obamacare will be rating health insurance plans based on how many doctors and hospitals are in their networks.  BUT (as I am your interpreter of bulls*#$) this doesn’t necessarily mean that doctor networks are going to improve for individual plans.  It just means there’s more transparency for you to make informed choices.

 

The PHEW! news: there’s a new thing next year called “continuity of care.”   What do you do if your doc leaves your network?  Often they leave or get dropped from the network without any heads up to YOU.  BUT in 2017, if you’re in an “active course of treatment,” you’ll be able to continue seeing the doctor if they leave the network.

 

The BAD news: out-of-pocket maximums are going up.  WAY UP!  In some states, they’ll increase from $6500 to $7150 for individuals, and from $13,000 to $14,300 for a family.

 

The YUCKY news: The Beacon article anticipates that deductibles in most states will see increases , too.

 

The WORST news: hold on to something…  premium increases are on the horizon for 2017.

 

The more you know, the more prepared you’ll be for 2017.…

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August 3rd, 2016

“What’s Up, Doc?” Blog Series Part 9: The Doorknob Moment… and Other Missed Opportunities

Welcome back to our series, “What’s Up, Doc?”  You can check out the first, second, third, fourth, fifth, sixth, seventh, or eighth parts by clicking the hyperlinks to get up to speed.  And now, “The Doorknob Moment… and Other Missed Opportunities.”

 

  1. Be your own team!  Prepare in advance for your visit.   Patients who take a more active role in their medical care have better physiological improvement.  Remember, this is a TEAM effort between you and the doctor… with you as the Team Captain!
  2. Ask your most important FAQs first!   Don’t wait until you’re dressed and leaving the office!  They say in psychotherapy the most impactful part of the session is usually the last 5 minutes.  Don’t take that approach with your medical doctor or you could miss talking about some important info.
  3. This tip is for the fellas:  speak up!  Don’t be macho, tell the truth.  If something is ailing you, it’s better for your doctor to know so she can help.   This visit is not the place to put on a brave face.    Statistically, women are better than men at asking questions about their medical issues.  Not that we’re better or anything (wink, wink), we just go to the doctor more often so we have more practice.
  4. ASK if the doctor will communicate by e-mail.   Often e-mails become a valuable part of your chart.   If you happen to forget to ask an important FAQ or need further clarification, having a doctor who uses technology is critical!
  5. If the doctor doesn’t use email, find out the easiest way to communicate with her after the visit… phone, fax, carrier pigeon, smoke signals?    For example, does she return phone calls after normal office hours?  What about in real emergencies?

 

Look at how smart …

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July 27th, 2016

“What’s Up, Doc?” Blog Series Part 8: A Cure For What Ails You

Hello again, my avid readers.  Hugs for reading the first, second, third, fourth, fifth, sixth, and seventh of our series, “What’s Up, Doc?”

 

Last time, we left you sitting on the slab as the doctor came into the room.   And now a segment we call “A Cure for What Ails You” and is a continuation of advice from last week on what to do once you have their ear.

 

First and foremost, I like the concept that the doctor works FOR YOU!   Not the other way ‘round.   You are paying that person… she works for you!   You deserve her time and FULL attention.   Remember, you get a vote.   And not just any vote.. you get THE vote on how things proceed!!

 

  1. If you need tests, remind the doctor to use ONLY an in-network lab.
  2. If you need meds, ask if the generic is available.   YOU control how you spend your money!  The docs generally don’t think twice about prescribing expensive brand name drugs.
  3. Did the doctor advise seeing a specialist?  Ask for their IN-network referrals for a trusted doc before you leave.   But it’s still up to YOU to verify that the new doc is IN-network!
  4. If you need a follow-up visit, make the appointment before you leave!
  5. Remember to request a copy of the chart notes from today’s visit.
  6. ASK if the doctor will communicate by e-mail.   Often e-mails become a valuable part of your chart.

 

Who is your fave doc?  What have they done that makes them your fave?  Always love the shares from friends of The Insurance Mom.…

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July 20th, 2016

“What’s Up, Doc?” Blog Series Part 7: The Doctor is in! Now What?!

Look at you, friend of The Insurance Mom!  You’ve learned so much from our first, second, third, fourth, fifth, and sixth parts of our series, “What’s Up, Doc?” Don’t you feel well-informed and powerful!?
Here’s the next revelation, “The Doctor is In!  Now What?”

 

  1. Remind Doc Hollywood of any important medical history.   Do NOT assume they remember everything about you.  If you’re seeing this doctor for the first time give a brief summary of important medical history.
  2. As I mentioned in the second part of our series, always have a current copy of your medical records.   Before seeing a new doc for the first time, email a copy of your chart FIRST.    Hopefully, this will get your new doc up to speed before you get there.
  3. If you’re there for a physical (aka check-up, aka preventive care), remind the doctor that’s the ONLY purpose for your visit.    I want YOU to give explicit permission to the doc if she’s going to do additional tests or treatments that are NOT included in your free physical.  The Insurance Mom also recommends referencing this website which lists all of the stuff that has to  be covered by your insurance (it’s part of the Affordable Care Act!)… so you know your rights!
  4. Ask LOTS of FAQs.   There is always another question to ask!   So ASKAsk for clarification if you need it.  Ask the doctor WHY she is recommending this particular course of treatment or prescription.  Ask about side-effects.  Ask about likely outcomes.    Ask what alternative options may be available.   Just because a doctor makes a suggestion, doesn’t mean it’s a recommendation… or the best recommendation.

Thanks for following along to our virtual tour of the doctor’s office!  Now, talk to me.  Share your funny / interesting …

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July 13th, 2016

“What’s Up, Doc?” Blog Series Part 6: Cold and Alone, Wearing Paper… Make the Most of the Exam Room

You get a gold star for adult-ing, my friends!  Thank you for tuning in to “Cold and Alone, Wearing Paper: Make the Most of the Exam Room.”  Check out the first, second, third, fourth and fifth parts of our series, “What’s Up, Doc?” to get caught up to speed!

 

OK, you’re finally in the exam room.  While you’re shivering in the paper gown and bored of looking at Highlights Magazine, contemplate how you can get the most bang for your buck.

 

  1. Think of the most important thing you’re concerned about for THIS visit.   Start with this topic!   Narrow down the focus so you can use the doctor’s time to your advantage.
  2. Studies show that a doctor stops actively listening after about 30 seconds before she starts taking notes or typing.   I like to make sure the doctor is looking at me and having a dialogue before she starts charting her impressions!
  3. Remember that list of important questions you made before the visit?  Now’s the time to whip it out!
  4. Did your friend come with you?  Remind them what you’d like to accomplish.  And buy them a Starbucks when you leave. 🙂  Don’t have a BFF available to attend the visit?  Use the voice memo app on your phone.   Technology is great when we use it, am I right?
  5. Heads-up… before you leave ANY doctor’s appointment, ask for a copy of that day’s chart notes for your records!   I’ve never had a doc refuse my request.
  6. Be absolutely sure that what the doc wrote in your chart is REALLY what you talked about and reflects the tests or treatments or medications to which you’ve explicitly
  7. Correct any mistakes in an email and fax to the doctor!

 

Learning lots?  Now teach me what you know!  I …

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July 6th, 2016

“What’s Up, Doc?” Blog Series Part 5: Make the Most of Your Waiting Room Time

OK, family!  You’re in it to win it.  Thanks for tuning in for our first, second,  third, and fourth parts of our blog series, “What’s Up, Doc?”   We’re giving you tips starting from the first little inkling of the need to see a doctor to a diagnosis.

 

Today, we’re on our fifth part in our series, “Make the Most of Your Waiting Room Time.”  You’ve arrived at the doctor’s office and they’ve taken your name.  So now what, Insurance Mom?  Here you go…

 

  1. On the day of your appointment, call and ask if the doctor is running on time.  If they’re running late, sometimes the receptionist can give you a heads up that you can arrive a bit later.  Less waiting in waiting rooms when you’re feeling under the weather!
  2. Look at your insurance ID card so you know what your IN-network office visit co-pay is.    Remember, that the office visit co-pay is what the doctor charges you just for showing up!   Sometimes the office visit fee is all you’ll pay for a consult.  But sometimes, you will also pay for any medical services the doctor does to/for you.
  3. On ALL plans that comply with the ACA (ObamaCare), you get one FREE check-up a year with an IN-network provider – NO co-pays required!.    If you’re seeing the doc for your annual physical, know ahead of time exactly WHAT services are covered.   And make sure you do not get charged for the visit.
  4. For a list of what’s covered, see this webpage for guidelines.   Take the list with you so you can show it to the doctor.   You’d be surprised how much the doctors don’t know about the ACA!!

 

Please keep me posted on any thoughts or questions that come up while reading.  …

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June 29th, 2016

“What’s Up, Doc?” Blog Series Part 4: Homework to Do Before Your Appointment!

Welcome back to our blogginess, “What’s Up, Doc?” You can find the first, second, and third parts in our series with those hyperlinks, hopefully giving you a Grey’s Anatomy to getting good healthcare.  😉

 

Today, we hit “Homework to Do Before Your Appointment!”

 

  1. Always have a current copy of your medical records.    Heads-up… before you leave ANY doctor’s appointment, ask for a copy of that day’s chart notes for your records!   I’ve never had a doc refuse my request.
  2. If you’re going to a new doc for the first time, email or fax a copy of your chart FIRST.    Hopefully, this will get your new doc up to speed before you get there.
  3. Your “go bag” should include a list of current medications and a record of any recent visits to other docs, why you went, and what happened.
  4. Write down your questions before the visit.   It’s easy to forget when you’re not feeling well!  Make a short list of other concerns and take it with you.   You can always come back to talk about other stuff, but what was the primary cause of making this appointment?    Stay focused!
  5. Ask  a friend to go with you.   It’s good to have a BFF in the room to write down what the doctor said… and to ask important questions which may not occur to you.   And it’s good to have loving support in the room, too, especially when you’re feeling scared!    “Selective hearing” is real and it happens!

 

Tune in next time for what to do you when you finally get to your appointment.

 

As always, I love hearing from my peeps.  Share your tips and tricks with me!…

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